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Subarachnoid hemorrhage randomized

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https://www.readbyqxmd.com/read/29048544/valproic-acid-attenuates-the-risk-of-acute-respiratory-failure-in-patients-with-subarachnoid-hemorrhage
#1
Wen-I Liao, Wu-Chien Chien, Chi-Hsiang Chung, Jen-Chun Wang, Tzu-Tsao Chung, Shi-Jye Chu, Shih-Hung Tsai
Background: To determine whether the use of valproic acid (VPA) is associated with a decreased risk of acute respiratory failure (ARF) in patients with subarachnoid hemorrhage (SAH). Methods: The Taiwan National Health Insurance Research Database was used to analyze all patients newly diagnosed with SAH from 2000 to 2010. The VPA users were matched for age, gender and index date in 1:2 ratios with randomly selected non-VPA users as a comparison group. Multivariate Cox regression was used to identify the predictors of ARF and to compare the incidence rates of ARF among SAH patients using and not using VPA...
October 18, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29031080/endovascular-therapy-for-vasospasm-secondary-to-subarachnoid-hemorrhage-a-meta-analysis-and-systematic-review
#2
REVIEW
Zhong Yao, Xin Hu, Chao You
Endovascular therapy has been used as an alternative treatment for vasospasm following subarachnoid hemorrhage. The effectiveness and safety of endovascular therapy are still controversial. We performed a systematic review and meta-analysis to identify any advantage of endovascular therapy over traditional medical treatment. We systematically reviewed related English publications by searching PubMed, Ovid, Cochrane library, and Web of Science up to May 2017.The risk ratios (RR) and 95% confidence intervals (CI) were synthesized with fixed effect model...
October 9, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29021779/xenon-reduces-neuronal-hippocampal-damage-and-alters-the-pattern-of-microglial-activation-after-experimental-subarachnoid-hemorrhage-a-randomized-controlled-animal-trial
#3
Michael Veldeman, Mark Coburn, Rolf Rossaint, Hans Clusmann, Kay Nolte, Benedikt Kremer, Anke Höllig
OBJECTIVE: The neuroprotective properties of the noble gas xenon have already been demonstrated using a variety of injury models. Here, we examine for the first time xenon's possible effect in attenuating early brain injury (EBI) and its influence on posthemorrhagic microglial neuroinflammation in an in vivo rat model of subarachnoid hemorrhage (SAH). METHODS: Sprague-Dawley rats (n = 22) were randomly assigned to receive either Sham surgery (n = 9; divided into two groups) or SAH induction via endovascular perforation (n = 13, divided into two groups)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28989143/-protective-effect-of-mitochondria-targeted-antioxidant-ss31-on-early-brain-injury-following-subarachnoid-hemorrhage-in-rats
#4
Jian Zhou, Zhengzheng Li, Zhenggang Chen, Kun Yang
To evaluate protective effects of SS31 on early brain injury (EBI) induced by subarachnoid hemorrhage (SAH) in rats.
 Methods: A total of 96 Sprague-Dawley rats were randomly divided into 4 groups: A sham group, an SAH group, an SAH+vehicle group (SAH+V), and an SAH+SS31 group. The SAH-induced prechiasmatic cistern rat model was established in this study. Neurological deficit scores were evaluated at 24 h after SAH. The SS31 (5 mg/kg) as well as equal volume of vehicle were administrated intraperitoneally at 2 h after SAH...
September 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28987848/prevention-and-treatment-for-hyponatremia-in-patients-with-subarachnoid-hemorrhage-a-systematic-review
#5
REVIEW
Kieran Shah, Ricky Turgeon, Peter A Gooderham, Mary H H Ensom
BACKGROUND: Current guidelines have not systematically assessed the literature for the management of hyponatremia in patients with subarachnoid hemorrhage. OBJECTIVE: To evaluate the efficacy and safety of current preventative and treatment strategies of hyponatremia in patients with subarachnoid hemorrhage. METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, MEDLINE, and PubMed for relevant studies. Primary outcomes of interest included neurological functional outcomes, symptomatic vasospasm, and others...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28973585/characteristics-of-unruptured-compared-to-ruptured-intracranial-aneurysms-a-multicenter-case-control-study
#6
Isabel C Hostettler, Varinder S Alg, Nichole Shahi, Fatima Jichi, Stephen Bonner, Daniel Walsh, Diederik Bulters, Neil Kitchen, Martin M Brown, Henry Houlden, Joan Grieve, David J Werring
BACKGROUND: Only a minority of intracranial aneurysms rupture to cause subarachnoid hemorrhage. OBJECTIVE: To test the hypothesis that unruptured aneurysms have different characteristics and risk factor profiles compared to ruptured aneurysms. METHODS: We recruited patients with unruptured aneurysms or aneurysmal subarachnoid hemorrhages at 22 UK hospitals between 2011 and 2014. Demographic, clinical, and imaging data were collected using standardized case report forms...
July 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28966073/effect-of-simvastatin-in-patients-with-aneurysmal-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#7
REVIEW
Hongju Liu, Xiaoli Xu
BACKGROUND: Simvastatin might be beneficial to the patients with aneurysmal subarachnoid hemorrhage. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of simvastatin for aneurysmal subarachnoid hemorrhage. METHODS: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of simvastatin versus placebo on aneurysmal subarachnoid hemorrhage were included...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28945859/high-dose-nadroparin-following-endovascular-aneurysm-treatment-benefits-outcome-after-aneurysmal-subarachnoid-hemorrhage
#8
Rene Post, IJsbrand A J Zijlstra, Rene van den Berg, Bert A Coert, Dagmar Verbaan, W Peter Vandertop
BACKGROUND: Delayed cerebral ischemia (DCI) is one of the major causes of delayed morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: To evaluate the effect of high-dose nadroparin treatment following endovascular aneurysm treatment on the occurrence of DCI and clinical outcome. METHODS: Medical records of 158 adult patients with an aSAH were retrospectively analyzed. Those patients treated endovascularly for their ruptured aneurysm were included in this study...
July 27, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28886745/bayesian-dose-selection-design-for-a-binary-outcome-using-restricted-response-adaptive-randomization
#9
Caitlyn Meinzer, Renee Martin, Jose I Suarez
BACKGROUND: In phase II trials, the most efficacious dose is usually not known. Moreover, given limited resources, it is difficult to robustly identify a dose while also testing for a signal of efficacy that would support a phase III trial. Recent designs have sought to be more efficient by exploring multiple doses through the use of adaptive strategies. However, the added flexibility may potentially increase the risk of making incorrect assumptions and reduce the total amount of information available across the dose range as a function of imbalanced sample size...
September 8, 2017: Trials
https://www.readbyqxmd.com/read/28862545/sex-differences-in-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#10
Menno R Germans, Blessing N R Jaja, Airton Leonardo de Oliviera Manoel, Ashley H Cohen, R Loch Macdonald
OBJECTIVE In this study the authors sought to investigate the sex differences in the risk of delayed cerebral ischemia (DCI), delayed cerebral infarction, and the role of hormonal status. METHODS Ten studies included in the SAHIT (SAH International Trialists) repository were analyzed using a fitting logistic regression model. Heterogeneity between the studies was tested using I(2) statistics, and the results were pooled using a random-effects model. Multivariable analysis was adjusted for the effects of neurological status and fixed effect of study...
September 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28831717/a-randomized-trial-of-brief-versus-extended-seizure-prophylaxis-after-aneurysmal-subarachnoid-hemorrhage
#11
Theresa Human, Michael N Diringer, Michelle Allen, Gregory J Zipfel, Michael Chicoine, Ralph Dacey, Rajat Dhar
BACKGROUND: Seizures occur in 10-20% of patients with subarachnoid hemorrhage (SAH), predominantly in the acute phase. However, anticonvulsant prophylaxis remains controversial, with studies suggesting a brief course may be adequate and longer exposure may be associated with worse outcomes. Nonetheless, in the absence of controlled trials to inform practice, patients continue to receive variable chemoprophylaxis. The objective of this study was to compare brief versus extended seizure prophylaxis after aneurysmal SAH...
August 22, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28821992/analysis-of-outcome-at-discharge-after-aneurysmal-subarachnoid-hemorrhage-in-japan-according-to-the-japanese-stroke-databank
#12
Fusao Ikawa, Masaru Abiko, Daizo Ishii, Jyunpei Ohshita, Toshinori Matsushige, Takahito Okazaki, Shigeyuki Sakamoto, Eisuke Hida, Shotai Kobayashi, Kaoru Kurisu
The outcomes at discharge for ruptured cerebral aneurysms after subarachnoid hemorrhage (SAH) were investigated using data from the Japanese stroke databank. Among 101,165 patients with acute stroke registered between 2000 and 2013, 4693 patients had SAH caused by ruptured saccular aneurysm. Of these, 3593 patients (1140 men and 2453 women; mean age 61.3 ± 13.7 years) were treated by surgical clipping (SC) and/or endovascular coiling (EC). The outcomes of modified Rankin scale (mRS) at discharge were compared between the SC and EC groups...
August 19, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28808649/the-effect-of-a-single-dose-dantrolene-in-patients-with-vasospasm-following-aneurysmal-subarachnoid-hemorrhage
#13
Masih Sabouri, Mahmood Momeni, Fariborz Khorvash, Majid Rezvani, Homayon Tabesh
BACKGROUND: Cerebral vasospasm is a prolonged, occasionally severe, but reversible narrowing of the cerebral arteries that begins 3 to 5 days after the hemorrhage becomes maximal at 14 days. This study is designed to evaluate the effect of dantrolene on the reduction of vasospasm following aneurysmal subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: This randomized controlled clinical trial was conducted on 32 patients with proven aneurysms in AL-Zahra hospital during 2011-2013...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28762878/long-acting-statin-for-aneurysmal-subarachnoid-hemorrhage-a-randomized-double-blind-placebo-controlled-trial
#14
Masato Naraoka, Naoya Matsuda, Norihito Shimamura, Kenichiro Asano, Kenichi Akasaka, Atsuhito Takemura, Seiko Hasegawa, Hiroki Ohkuma
Statins have pleiotropic effects that are considered beneficial in preventing cerebral vasospasm and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage (aSAH). Many studies using statins have been performed but failed to show remarkable effects. We hypothesized that a long-acting statin would be more effective, due to a longer half-life and stronger pleiotropic effects. Patients with aSAH were randomly assigned to a pitavastatin group (4 mg daily; n = 54) and a placebo group ( n = 54) after repair of a ruptured aneurysm...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28698029/critical-role-of-epha4-in-early-brain-injury-after-subarachnoid-hemorrhage-in-rat
#15
Ruiming Fan, Budbazar Enkhjargal, Richard Camara, Feng Yan, Lei Gong, ShengtaoYao, Jiping Tang, Yangmei Chen, John H Zhang
Early brain injury (EBI) is reported as a primary cause of mortality in subarachnoid hemorrhage (SAH) patients. Eph receptor A4 (EphA4) has been associated with blood-brain barrier integrity and pro-apoptosis. We aimed to investigate a role of EphA4 in EBI after SAH. One hundred and seventy-nine male adult Sprague-Dawley rats were randomly divided into sham versus endovascular perforation model of SAH groups. SAH grade, neurological score, Evans blue dye extravasation, brain water content, mortality, Fluoro-Jade staining, immunofluorescence staining, and western blot experiments were performed after SAH...
October 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28697013/the-clinical-significance-of-isolated-traumatic-subarachnoid-hemorrhage-in-mild-traumatic-brain-injury-a-meta-analysis
#16
Farshad Nassiri, Jetan H Badhiwala, Christopher D Witiw, Alireza Mansouri, Benjamin Davidson, Saleh A Almenawer, Nir Lipsman, Leodante Da Costa, Farhad Pirouzmand, Avery B Nathens
BACKGROUND: The rates of clinical and radiographic progression and the need for neurosurgical intervention in patients with isolated traumatic subarachnoid hemorrhage (itSAH) after mild traumatic brain injury (Glasgow Coma Scale score, 13-15) has not been well established.The aim of this work was to review the evidence regarding patient outcomes after mild traumatic brain injury with itSAH. METHODS: Two authors independently extracted the data according to a predefined protocol...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28684727/plasmid-plxsn-mediated-adrenomedullin-gene-therapy-for-cerebral-vasospasm-following-subarachnoid-hemorrhage-in-rats
#17
Xin Li, Xiaoshuang Xia, Xin Li
BACKGROUND The aim of this study was to investigate the protective effect of ADM gene mediated by plasmid pVAX1 on cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH). MATERIAL AND METHODS The recombinant plasmid pVAX-ADM was successfully established, and 40 SD rats were randomly divided into normal saline, pVAX1, pVAX1-ADM low-dose, pVAX1-ADM mid-dose, and pVAX1-ADM high-dose groups. The circumference and diameter of basilar artery, diameter of middle cerebral artery and internal carotid artery, and thickness of basilar artery wall were observed...
July 7, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28682429/study-on-the-expression-and-mechanism-of-inflammatory-factors-in-the-brain-of-rats-with-cerebral-vasospasm
#18
Q Huang, G Wang, Y-L Hu, J-X Liu, J Yang, S Wang, H-B Zhang
OBJECTIVE: We investigated the significance of IL-1 and ICAM-1 in rat's subarachnoid hemorrhage (SAH) cerebral vasospasm (CVS) model. MATERIALS AND METHODS: A total of 30 Sprague-Dawley (SD) rats were randomly divided into the SAH group and the Sham group. Cisterna magna auto blood injection was used to prepare the CVS models. We studied and compared changes in the basilar arteries diameters before and after SAH. We measured the cerebrovascular inner diameter before and after SAH modeling using the ultrasound...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28665071/feasibility-and-safety-of-mild-therapeutic-hypothermia-in-poor-grade-subarachnoid-hemorrhage-prospective-pilot-study
#19
Wookjin Choi, Soon Chan Kwon, Won Joo Lee, Young Cheol Weon, Byungho Choi, Hyeji Lee, Eun Suk Park, Ryeok Ahn
Therapeutic hypothermia (TH) improves the neurological outcome in patients after cardiac arrest and neonatal hypoxic brain injury. We studied the safety and feasibility of mild TH in patients with poor-grade subarachnoid hemorrhage (SAH) after successful treatment. Patients were allocated randomly to either the TH group (34.5°C) or control group after successful clipping or coil embolization. Eleven patients received TH for 48 hours followed by 48 hours of slow rewarming. Vasospasm, delayed cerebral ischemia (DCI), functional outcome, mortality, and safety profiles were compared between groups...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28663521/intra-arterial-vasodilators-for-vasospasm-following-aneurysmal-subarachnoid-hemorrhage-a-meta-analysis
#20
Anand Venkatraman, Ayaz M Khawaja, Sahil Gupta, Shalaka Hardas, John P Deveikis, Mark R Harrigan, Gyanendra Kumar
OBJECTIVE: The efficacy of intra-arterial vasodilators (IADs) for the treatment of vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remains debatable. The objective of this meta-analysis was to pool estimates of angiographic and neurological response, clinical outcome, and mortality following treatment of vasospasm with IADs. METHODS: We searched PubMed, Embase, Scopus, Clinicaltrials.gov, Cochrane database, and CINAHL in December 2015 and August 2016...
June 29, 2017: Journal of Neurointerventional Surgery
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